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Analysis of Current Practice of CT examinations.

https://arctichealth.org/en/permalink/ahliterature91632
Source
Acta Oncol. 2009;48(2):295-301
Publication Type
Article
Date
2009
Author
Hansen Jolanta
Jurik Anne Grethe
Author Affiliation
Department of Medical Physics, Aarhus University Hospital, Aarhus Sygehus, Aarhus C, Denmark. jolanta@as.aaa.dk
Source
Acta Oncol. 2009;48(2):295-301
Date
2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Male
Middle Aged
Professional Practice - trends
Radiation Dosage
Radiation Injuries - epidemiology - etiology
Risk factors
Tomography, X-Ray Computed - utilization
Young Adult
Abstract
BACKGROUND: The number of CT examinations performed in Denmark increased from 14,500 examinations in 1979 to 301,617 in 2005. This implies increased radiation dose to the population. On this background, an analysis of the practice for CT examinations including potential limitations of radiation exposure and the associated risk is needed. PURPOSES: To analyse 1) the current use of CT in a university department compared to 1996, 2) the radiation dose and risk associated with the examinations and 3) the use of CT in Denmark since 1979. MATERIAL AND METHODS: The administrative data of CT examinations performed in the Department of Radiology, Aarhus Sygehus, during 2005 and 1996, respectively, were obtained. Additionally national CT data were obtained from the database at the National Board of Health. RESULTS: In 1996 1,840 patients obtained 5,538 CT examinations at Aarhus Sygehus. Their mean age was 46.7 years (0-88). The most frequent referring speciality was oncology followed by abdominal surgery and orthopaedic surgery. In 2005 3,769 patients obtained 11,216 CT examinations. They were generally older with a mean age of 56.9 years (0-97). The most frequent referring speciality was oncology followed by chest medicine and abdominal surgery. In 2005 the total effective dose was 71,043 mSv (mean 18.9 mSv/per patient). According to the BEIR VII model this radiation level corresponded to a risk for inducing a cancer in 7 patients, being fatal in half of them. The national data showed a gradual increase of the number of CT examinations from 1979 to 2005, most pronounced after year 2000 coinciding with the introduction of multi-slice CT (MSCT). CONCLUSION: The number of CT examinations at Aarhus Sygehus doubled during a 9 year period. The increase occured especially in middle and high age groups.
PubMed ID
18923941 View in PubMed
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Changes in peritoneal dialysis practices in Canada 1996-1999.

https://arctichealth.org/en/permalink/ahliterature185871
Source
Perit Dial Int. 2003 Jan-Feb;23(1):53-7
Publication Type
Article
Author
Rafael A Perez
Peter G Blake
Kailash A Jindal
Kimberly Badovinac
Lilyanna Trpeski
Stanley S A Fenton
Author Affiliation
London Health Sciences Centre, ON, Canada.
Source
Perit Dial Int. 2003 Jan-Feb;23(1):53-7
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Creatinine - metabolism
Drug Prescriptions - statistics & numerical data
Humans
Peritoneal Dialysis, Continuous Ambulatory - statistics & numerical data
Practice Guidelines as Topic
Professional Practice - trends
Abstract
Over the past decade, clinical studies and clinical practice guidelines have suggested the use of higher small solute clearance targets for patients on peritoneal dialysis (PD). This study asks whether these recommendations have translated into changes in clinical prescription of PD.
Data were collected annually from 1996 to 1999 on all prevalent dialysis patients in 24 Canadian centers, accounting for approximately 40% of the Canadian chronic dialysis population. Approximately a third of these patients were on PD. Full details of each patient's prescription were recorded, with particular attention to dwell volumes and frequency of exchanges for continuous ambulatory PD (CAPD) and to total treatment volumes and day dwells for automated PD (APD). The most recent Kt/V and creatinine clearance values available were recorded for each patient and the overall results for each year were compared to present treatment recommendations.
24 university- and community-based hospitals.
From 1996 to 1999, the use of APD, relative to CAPD, grew from 14% to 28% of all PD patients. Among CAPD patients, the proportion using dwell volumes greater than 2 L rose from 14% to 32%, and the proportion doing more than 4 dwells per day rose from 16% to 28%. The mean daily volume of prescribed fluid for CAPD patients increased from 8.3 to 9.1 L. As a result, the proportion of patients achieving a weekly Kt/V above 2.0 rose from 54% to 72%, and those receiving a Kt/V less than 1.7 fell from 22% to 10%. For creatinine clearance, those exceeding 60 L per week rose from 63% to 73%. For APD, the mean treatment volume rose from 11.8 L in 1996 to plateau at about 13.4 L in 1998 and 1999. However, the proportion of patients receiving more than 1 day dwell grew from 31% in 1998 to 40% in 1999, and the proportion that were "day dry" fell from 25% to 17%. For APD, the proportion of patients with a Kt/V above 2.0 rose from 67% to 77%, and with a creatinine clearance above 60 L, from 62% to 70%. The proportion with no recent clearance value recorded fell during the course of the study, from 45% to 27%.
There was a marked change in PD prescription practices in Canada during the second half of the 1990s. This occurred in response to clinical studies and publication of guidelines. There is room for further improvement, especially with respect to the proportion of patients that did not have regular clearance measurements made.
PubMed ID
12691507 View in PubMed
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Source
Can Fam Physician. 1998 Oct;44:2143-9
Publication Type
Article
Date
Oct-1998
Author
M J Bass
I R McWhinney
M. Stewart
A. Grindrod
Author Affiliation
Department of Family Medicine, University of Western Ontario (UWO), London.
Source
Can Fam Physician. 1998 Oct;44:2143-9
Date
Oct-1998
Language
English
Publication Type
Article
Keywords
Family Practice - trends
Female
Health Care Surveys
House Calls - statistics & numerical data
Humans
Job Satisfaction
Male
Ontario
Physicians, Family - psychology - statistics & numerical data - trends
Professional Practice - trends
Questionnaires
Urban Health Services - trends
Workload - statistics & numerical data
Abstract
To identify trends in family practice in London, Ont, between 1974 and 1994.
Interview survey of all London family physicians in 1974. Questionnaire surveys in 1984 and 1994.
City of London, Ont.
One hundred twenty-eight family physicians and general practitioners practising in London in 1974, 180 in 1984, and 237 in 1994.
The percentage of female practitioners, practitioners with no in-hospital patients, and practitioners making no home visits in an average week increased significantly. The percentage of solo practitioners and family physicians practising obstetrics decreased significantly. Changes were found in the numbers of patients seen, in weekend coverage, in evening, and Wednesday afternoon office hours, and in level of satisfaction with practice.
Fewer physicians cared for in-hospital patients, made home visits, practised solo, and delivered babies in 1994 than in 1974. Substantially more women were practising family medicine in 1994 than in 1974. The trend away from in-hospital care, with no corresponding increase in home care, raises questions about how urban family physicians can maintain certain clinical skills.
Notes
Cites: Can Fam Physician. 1993 Jun;39:1356-658324405
Cites: CMAJ. 1993 Dec 15;149(12):1795-8008261349
Cites: Can Fam Physician. 1994 Feb;40:249-568130673
Cites: Can Fam Physician. 1994 Feb;40:261-88130674
Cites: Can Fam Physician. 1996 Dec;42:2370-98969856
Cites: CMAJ. 1995 Oct 15;153(8):1097-1067553517
Cites: CMAJ. 1995 Nov 15;153(10):1447-527585371
Cites: Can Fam Physician. 1996 Oct;42:1939-448894240
Cites: Can Fam Physician. 1996 Nov;42:2170-88939318
Cites: CMAJ. 1995 Jun 1;152(11):1789-977773895
PubMed ID
9805169 View in PubMed
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Dental hygiene practice: international profile and future directions.

https://arctichealth.org/en/permalink/ahliterature62884
Source
Int Dent J. 1992 Dec;42(6):451-9
Publication Type
Article
Date
Dec-1992
Author
P M Johnson
Author Affiliation
School of Health Sciences, Seneca College of Applied Arts and Technology, North York, Ontario, Canada.
Source
Int Dent J. 1992 Dec;42(6):451-9
Date
Dec-1992
Language
English
Publication Type
Article
Keywords
Australia
Certification
Delivery of Health Care
Dental Hygienists - education - supply & distribution - trends
Employment
Europe
Female
Forecasting
Humans
Licensure
Male
North America
Professional Practice - trends
Socioeconomic Factors
Abstract
Results of an international survey on dental hygiene are reported. The survey was conducted in 1988 through the International Dental Hygienists' Federation as part of a project to establish and maintain an international database on the profession. Information was collected by mail from national dental hygienist associations, using a 40-item questionnaire developed for the purpose; preliminary tabulations were validated by the associations. Information is presented for 13 countries-Australia, Canada, Denmark, Italy, Japan, Korea, The Netherlands, Nigeria, Norway, Sweden, Switzerland, the United States and the United Kingdom. Characteristics include historical development, numbers and distribution, education, regulation, scope of practice, employment settings and conditions, professional organisation, and perceived oral health and professional issues. The profiles and issues are examined in the light of broader socio-economic, demographic, epidemiological, technological and policy-related trends and changes. Implications for future health and organisational planning are noted.
PubMed ID
1286929 View in PubMed
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Evolution in the practice of pharmacy--not a revolution!

https://arctichealth.org/en/permalink/ahliterature163985
Source
CMAJ. 2007 Apr 24;176(9):1295-6
Publication Type
Article
Date
Apr-24-2007
Author
Glen J Pearson
Author Affiliation
Division of Cardiology, University of Alberta, Suite 2C2 Walter C. Mackenzie Health Sciences Centre, 8440-112th St., Edmonton. glenpearson@capitalhealth.ca
Source
CMAJ. 2007 Apr 24;176(9):1295-6
Date
Apr-24-2007
Language
English
Publication Type
Article
Keywords
Canada
Drug Prescriptions
Humans
Legislation, Pharmacy
Pharmacy - trends
Professional Practice - trends
Professional Role
Notes
Cites: Am J Health Syst Pharm. 2004 Aug 1;61(15):1609-1015372838
Cites: Soc Sci Med. 1986;23(11):1187-2003810205
Cites: CMAJ. 2006 Aug 29;175(5):463-416940256
Cites: J Pharm Pharm Sci. 2005;8(2):217-2516124933
Cites: Am J Health Syst Pharm. 1999 Sep 1;56(17):1758-6410512508
PubMed ID
17452664 View in PubMed
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Exodus: why I limited my scope of practice.

https://arctichealth.org/en/permalink/ahliterature160844
Source
Can Fam Physician. 2007 Oct;53(10):1748-9
Publication Type
Article
Date
Oct-2007
Source
Can Nurse. 2013 Nov;109(9):4
Publication Type
Article
Date
Nov-2013

Health care, medical practice, and medical ethics in Russia today.

https://arctichealth.org/en/permalink/ahliterature215112
Source
JAMA. 1995 May 24-31;273(20):1569-73
Publication Type
Article
Author
B R Cassileth
V V Vlassov
C C Chapman
Author Affiliation
Department of Medicine, University of North Carolina at Chapel Hill, USA.
Source
JAMA. 1995 May 24-31;273(20):1569-73
Language
English
Publication Type
Article
Keywords
Complementary Therapies
Delivery of Health Care - trends
Ethics, Medical
Government Regulation
Health status
Humans
Internationality
Patient Advocacy
Patient Rights
Professional Practice - trends
Public Health - trends
Resource Allocation
Russia
Notes
Comment In: JAMA. 1995 May 24-31;273(20):1622-37745779
PubMed ID
7745761 View in PubMed
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Health promotion and empowerment: reflections on professional practice.

https://arctichealth.org/en/permalink/ahliterature219317
Source
Health Educ Q. 1994;21(2):253-68
Publication Type
Article
Date
1994
Author
R. Labonte
Source
Health Educ Q. 1994;21(2):253-68
Date
1994
Language
English
Publication Type
Article
Keywords
Canada
Consumer Participation - trends
Health Education - trends
Health Plan Implementation
Health Promotion - trends
Health Services Needs and Demand - trends
Humans
Medical Indigency - trends
Patient Care Team - trends
Politics
Power (Psychology)
Professional Practice - trends
Public Health - trends
Abstract
Recent reformulations of health promotion focus on empowerment as both a means and an end in health promotion practice. Both concepts, however, are rarely examined for their assumptions about social change processes or the potential of community groups, professionals, and institutions to create healthier living situations. This article attends to some of these assumptions, expressing ideas generated during 6 years of professional training workshops with over 2,500 community health practitioners in Canada, New Zealand, and Australia. The article first argues that health promotion is not a social movement but a professional and bureaucratic response to the new knowledge challenges of social movements. As such, it has both empowering and disempowering aspects. The article analyzes empowerment as a dialectical relation in which power is simultaneously given and taken, and illustrates this in the context of health promotion programs. A model of an empowering professional (institutional) health promotion practice is presented, in which linkages among personal services, small group supports, community organizing, coalition advocacy, and political action are made explicit. Practice examples are provided to illustrate each level of the empowering relation, and the article concludes with a brief discussion of the model's educational and organizational utility.
PubMed ID
8021151 View in PubMed
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25 records – page 1 of 3.